Hospital acquired anemia can be an issue if multiple tubes are collected several times a day. Over time, small amounts of blood (5 mL is a teaspoon) add up. I’ve developed a “short draw” protocol to use low volume tubes and chart the amount drawn for Read More...

When I blogged about looking at inpatient charts in 2012, we had implemented CPOE (Computerized Physician Order Entry) to a limited degree. Now that it’s commonplace and there are few written physician orders, it’s still useful to look at charts. Each Read More...

Many years ago when I was taught to run a Monospot, I was instructed in the fine art of rotating the card in a figure 8. The goal was to equally rotate the mixtures in all circles while scanning for agglutination. But in case that was too difficult, vendors Read More...

As a profession, we are used to having the answers: glucose values, compatible units of blood, pathogens in a urine culture. As simple as this seems to outsiders who see lab techs as mere button pushers, we know there is a lot of judgment involved. In Read More...

One of our more common complaints is that we didn’t do the correct test. We missed a test because it was not seen, illegible, or written on the back of a two-sided form; we assumed an abbreviation meant something unintended by the physician; we entered Read More...

Hematuria, or blood in the urine, is distinct from microhematuria . The latter isn’t visible to the naked eye and is detected under the microscope. (The prefix micro is from the Greek mikros , meaning “small.”) It isn’t unusual in urinalysis to see a Read More...

Our tendency to comment results with disclaimers is strong. Examples: Reporting pathogens in a urine culture with many skin flora and adding “possible contamination” Reporting a potassium on a hemolyzed sample and adding “hemolysis may increase results” Read More...

In 2011 I blogged about using a binary search algorithm to find a point of failure when performing a sample lookback with a large number of samples. In dealing with sample lookback and revising our own policies since then, we’ve hit a few snags: How should Read More...

The more I hear about diabetes, the worse it sounds. The statistics on the disease, recently updated by the CDC, are alarming: 29.1 million people have diabetes (9.3% of the US population) 8.1 million people are undiagnosed (about 1 in three with the Read More...

The bread and butter of labs are those tests ordered on most patients: chemistry panels, blood counts, urinalysis and culture, and to an extent coagulation and blood bank. These are often ordered serially on patients admitted to your hospital, creating Read More...

The nitroprusside test typically performed with a Bayer Acetest tablet is a laboratory classic. It’s one of the first tests I learned. In the nitroprusside reaction, acetoacetic acid, a serum or urine ketone, reacts with sodium nitroferricyanide and glycine Read More...

We do a lot of counting in the laboratory: white blood cells, abnormal red cells, urine formed elements, and microbiology colony counts. I’ve worked in labs where these are precise, for example, reporting urine microscopic red cells as rare, few, 0-1, Read More...

Running lab tests can look easy but often isn’t. Consider a common serology test, the heterophile screen. The OSOM Mono Test is one random example. The package insert lists the following with pictures: For serum, plasma, or whole blood samples in tubes: Read More...

The more I deal with process design, the more I suspect human error is systemic. Not that we are flawless workers -- one author parses mistakes and slips by intention or outcome -- but we give the system a pass too often and blame human error. We work Read More...

Our laboratory uses many “plop plop fizz fizz” tests for qualitative screening, like most labs. These quick and easy tests have been in labs as long as I can remember with a few enhancements over the years that have made them even easier e.g. internal Read More...